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Respiratory II > Obstructive lung diseases > Flashcards

Obstructive lung diseases Flashcards

1
Q

Type of lung disease indicated by decreased FEV1 and FEV1/FVC, and increased TLC and RV.

A

Obstructive lung diseases

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2
Q

Curvilinear flow-volume loop is seen in what type of lung disease

A

Obstructive

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3
Q

Lung disease characterized by mucous gland hyperplasia and hypersecretion within the bronchi.

A

Chronic bronchitis

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4
Q

Lung disease characterized by smooth muscle hyperplasia, excess mucous, and inflammation within the bronchi.

A

Asthma

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5
Q

Lung disease characterized by airspace enlargement and wall destruction in the acini.

A

Emphysema

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6
Q

Airway dilation and scarring in response to persistent or severe infections

A

Bronchiectasis

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7
Q

Most common type of emphysema

A

Centriacinar/centrilobular

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8
Q

Emphysema type commonly in the lower lung zones, involving the acinus.

A

Panacinar/panlobular

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9
Q

Type of emphysema seen in alpha-1 antitrypsin deficiency

A

Pancacinar/panlobular

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10
Q

Emphysema type associated with spontaneous pneumothorax in young adults. Seen adjacent to the pleura, and adjacent to areas of fibrosis, scarring, or atelactasis

A

Distal acinar

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11
Q

Emphysema characterized by subpleural blebs >1 cm

A

Bullous

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12
Q

Clinically insignificant emphysema type associated with scarring

A

Irregular

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13
Q

Gene mutation in alpha-1 antitrypsin deficiency

A

PiZZ (proteinase inhibitor) on chromosome 14

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14
Q

Change in pressure-volume curve in emphysema

A

Up and to the left

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15
Q

Entrance of air into the CT stroma of the lung, mediastinum, or subcutaneous tisse

A

Interstitial emphysema

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16
Q

Lung expands because air is trapped within it by tumor or foreign object, but there is no airway destruction

A

Obstructive overinflation

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17
Q

Pathogenesis of complications in emphysema

A

Damage to capillary bed
Hypoxic vasoconstriction
Secondary pulmonary HTN
Development of cor pulmonale
CHF

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18
Q

RHF secondary to a lung disease

A

Cor pulmonale

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19
Q

Clinical definition of chronic bronchitis

A

Productive cough for a least 3 months during 2 consecutive years without other cause

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20
Q

Inflammatory mediators in chronic bronchitis

A

Histamine
IL-13

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21
Q

Obstructive lung disease with an increased Reid index

A

Chronic bronchitis

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22
Q

Ratio of thickness of the gland layer to the thickness of the submucosa

A

Reid index

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23
Q

Hyperemia, swelling and edema of the mucous membranes of the lungs on gross inspection of cross section. Excessive mucinous or mucopurulent secretions. Heavy cases of secretions and pus fill the bronchi and bronchioles

A

Chronic bronchitis

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24
Q

Microscopy of the lung shows thickening of bronchiolar wall due to smooth muscle hypertrophy, goblet cell hyperplasia, and striking enlargement mucus-secreting glands of trachea and bronchi

A

Chronic bronchitis

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25
Q

Maximum thickness of the bronchial mucus glands internal to the cartilage divided by the bronchial wall thickness

A

Reid index

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26
Q

Normal Reid index value

A

0.4

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27
Q

DLCO in chronic bronchitis

A

Normal

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28
Q

DLCO in emphysema

A

Decreased

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29
Q

Pressure volume in chronic bronchitis in absence of emphysema

A

Nearly normal

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30
Q

Complications of chronic bronchitis

A

Pulmonary HTN
Cor pulmonale
Respiratory failure
Hypercapnia
Respiratory acidosis

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31
Q

GOLD stage of COPD with a decreased FEV1/FVC and normal FEV1.

A

Stage 1 - mild

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32
Q

GOLD stage of COPD with decreased FEV1/FVC and FEV1 between 50-80%.

A

Stage II - moderate

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33
Q

GOLD stage of COPD with decreased FEV1/FVC and FEV1 between 30-50%

A

Stage III - severe

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34
Q

GOLD stage of COPD with FEV1/FVC decreased and FEV1 <30%, or <50% with signs of respiratory failure or RHF.

A

Stage IV - very severe

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35
Q

Haldane effect

A

Administered O2 displaces CO2 bound to Hgb, increasing free CO2

36
Q

Sign of irreversible bronchoconstriction in post-bronchodilator test

A

Change in FEV1 <=12%

37
Q

General values of PO2 and PCO2 in respiratory failure

A

PO2 <60 mmHg
PCO2 >50 mmHg

38
Q

4 general causes of hypoxemia

A

Hypoventilation
Diffusion impairment
Shunt
V/Q mismatch

39
Q

Pulmonary causes of V/Q mismatch

A

Obstructive lung diseases - chronic bronchitis
Restrictive lung disease
Pulmonary vascular disease
Acute respiratory distress syndrome (ARDS)

40
Q

Chronic obstructive airway disease with variable expiratory outflow obstruction. Characteristic airway inflammation.

A

Bronchial asthma

41
Q

Most common type of asthma

A

Atopic

42
Q

Hypersensitivity reaction in atopic asthma

A

Type 1 hypersensitivity reaction

43
Q

Inflammatory mediators seen in atopic asthma

A

Leukotrienes
Prostaglandin D2
Histamine
Serotonin
IL-4
IL-5
IL-13

44
Q

Affect of inflammatory mediators in atopic asthma

A

Bronchoconstriction
Increased vascular permeability
Increased mucous secretion

45
Q

Triggers of nonatopic asthma

A

Viral respiratory infections - most common
Inhalants
Cold
Exercise

46
Q

Types of asthma

A

Atopic
Nonatopic
Drug induced
Occupational

47
Q

Samter’s triad

A

Asthma
Aspirin sensitivity
Nasal polyposis

48
Q

Agent often implicated in drug induced asthma

A

Aspirin

49
Q

Microscopy of lung shows goblet cell hyperplasia, sub-basement membrane fibrosis, eosinophilic inflammation, and muscle hypertrophy

A

Asthma

50
Q

Mucous plugs with whorls of shed epithelium

A

Curschman spirals

51
Q

Collections of crystalloids made of eosinophil proteins (galectin-10)

A

Charcot-Leyden crystals

52
Q

Curschman spirals and Charcot-Leyden crystals are seen in what obstructive lung disease

A

Asthma

53
Q

DLCO in asthma

A

Often increased

54
Q

Methacholine challenge test

A

> /=20% decrease in FEV1 in response to provoking factor

55
Q

Destruction of smooth muscle and elastic tissue of lungs by persistent or severe infections causing permanent dilation of bronchi and bronchioles

A

Bronchiectasis

56
Q

Congenital/hereditary conditions predisposing for bronchiectasis

A

Cystic fibrosis
Immunodeficiency states
Primary ciliary dyskinesia

57
Q

Dilated bronchi on cut surface of lungs appears cystic and filled with mucopurulent secretions

A

Bronchiectasis

58
Q

Microscopy of lung shows intense inflammatory cells, ulcerations of bronchial lining, squamous metaplasia, fibrosis, and destruction.

A

Bronchiectasis

59
Q

Complications of bronchiectasis

A

Metastatic brain abscess
Secondary amyloidosis
Cor pulmonale

60
Q

Pt presents with new onset of foul smelling, sometimes bloody sputum. Cough is worse in the morning. They had a cough and mild fever over the last week.

A

Bronchiectasis

61
Q

Multi-system involvement of cystic fibrosis

A

Chronic lung disease
Pancreas insufficiency
Hepatic cirrhosis
Intestinal obstruction
Male infertility

62
Q

Inheritance of cystic fibrosis

A

Autosomal recessive

63
Q

Gene mutation of cystic fibrosis

A

CFTR on chromosome 7q31.2

64
Q

Anion channels affected in cystic fibrosis

A

Chloride channels
Potassium channels
Epithelial sodium channels (ENaC)
Gap junction channels

65
Q

Cellular processes affected in cystic fibrosis

A

ATP transport
Mucous secretion

66
Q

Class I cystic fibrosis

A

Defective protein synthesis –> absent CFTR

67
Q

Class II cystic fibrosis

A

Abnormal protein folding, processing, and/or trafficking –> absent CFTR

Phenylalanine at AA position 508

68
Q

Class III cystic fibrosis

A

Defective channel regulation

69
Q

Class IV cystic fibrosis

A

Defective CFTR channel

70
Q

Class V cystic fibrosis

A

Reduced functional CFTR

71
Q

Class VI cystic fibrosis

A

Decreased CFTR membrane stability

72
Q

Meconium ileus

A

Thick viscid mucus plugs in the small intestines of infants in CF

73
Q

Cause of male infertility in cystic fibrosis

A

Congenital bilateral absence of vas deferens

74
Q

Diagnosis of CF via sweat chloride analysis

A

> 60 mmol/L

75
Q

Diagnosis of CF via nasal transepithelial potential difference

A

More negative

76
Q

Inheritance of primary ciliary dyskinasia

A

Autosomal recessive

77
Q

Triad of Kartagener syndrome

A

Situs inversus
Bronchiectasis
Sinusitis

78
Q

Cause of decreased fertility in both males and females in primary ciliary dyskinesia

A

Immotile sperm
Dysfunctional fallopian tube cilia

79
Q

Risk factors for allergic bronchopulmonary aspergillosis

A

Asthma
Cystic fibrosis
Bronchiectasis

80
Q

Indications for lung transplant

A

End stage COPD
Idiopathic pulmonary fibrosis
Cystic fibrosis
Idiopathic/familial pulmonary arterial HTN
Sarcoidosis

81
Q

Most common reason for lung transplant

A

Cystic fibrosis

82
Q

Prophylaxis for CMV pneumonia in the first few weeks post lung transplant

A

Ganciclovir

83
Q

Prophylaxis for P jiroveci pneumonia in the first few weeks post lung transplant

A

Bactrim

84
Q

Acute lung transplant rejection

A

Graft vessel vasculitis

85
Q

Types of chronic lung transplant rejections

A

Bronchiolitis obliterans
Bronchiectasis
Pulmonary fibrosis

86
Q

Fibrosis, scarring, and progressive obliteration of the small airways

A

Bronchiolitis obliterans

Respiratory II (17 decks)

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